By Vivian Galletly, SLP
To be effective, therapy must be meaningful, functional and motivating. Choosing the right therapist is a first step in creating a treatment plan that is fun, as well as successful.
Making it meaningful
For a child with a learning difference, therapy is an integral part of his learning plan and critical to success in school and the community. Therapy that is meaningful, functional and motivating means goals are being met and learning is taking place. What makes therapy meaningful? The strategies used in therapy must make sense to the child, the parents and the therapists. Techniques that are random and have no basis in the child’s daily tasks and activities won’t carry over into the day-to-day and thereby won’t facilitate learning. Using flash cards with a child to build skills may not be as effective as engaging the child in an activity such as reading a book, using imaginary play or hands-on manipulatives. Therapists should be less concerned about procedure and more aware of which activities and exercises engage the child in learning. Parents can reinforce these skills by taking advantage of “teaching moments” during daily tasks and activities around the house.
Focus on function
Therapy that is meaningful leads naturally to therapy that is functional. When there are frequent opportunities within the daily routine for the child to practice target therapy goals then therapy is positively reinforced throughout the child’s day. If the child is in physical therapy and has a goal to climb stairs, then this goal should be practiced each time the child encounters stairs, rather than always being carried up the stairs. Even if this goal is challenging for the child, he will likely begin to accept this as part of his routine, because it is expected. This goal is functional since it addresses a goal, and meaningful as it becomes a part of the child’s daily life.
Keeping it motivating
To keep progressing, parents and therapists need to consistently re-evaluate what motivates the child. This is crucial to keep his attention on tasks and goals. Adapting activities and exercises to what engages the child’s body and intellect will help goals get reached. Whether the motivators are books, toys, movie characters, games or computer time, they are the child’s “standard of living” and reflect who he is. Many times a child seems uncooperative and/or unable to complete tasks when he is actually just uninterested. A therapist who recognizes, celebrates and accommodates a child’s personality and interests will see ability and potential shine through.
By using the guidelines below, parents can make sure their child’s therapy stays meaningful, functional and motivating.
1. Abandon assumptions about behavior
The therapist should perceive the child as an individual rather than overly identifying him with a particular learning difference or diagnosis. An effective therapist will perceive a child not as the sum of his diagnosis, but as an individual with specific reasons for specific behaviors. If a child is being willful, then it may be because of a certain medical condition or disorder, but it could also be for other reasons. Does your therapist ask questions in order to really know the child? Is the therapist conscientious of techniques that are not a good match for the child and willing to change them? Does he seek the reasons behind a certain behavior rather than just trying to correct the behavior itself?
2. Set appropriate goals and believe
Believing in a child’s ability and what he is capable of achieving allows therapists to set challenging yet realistic goals. The expectation level for the treatment plan should be frequently assessed to ensure the child’s goals are on target and progress is being made. Goals should be relevant to the child’s everyday tasks and activities. The idea is to put therapy into the day, not taking time out of the day to do therapy. Target goals should work towards naturally occurring opportunities such as fixing snacks, taking a bath, getting dressed, playing with others and helping around the house.
Goals should be age appropriate according to the child’s challenges and development schedule. Is the therapist familiar with typical development norms and levels? Is the therapist able to educate first-time parents as to what is typical development and what should be adapted according to the child’s learning difference?
3. Observe from every angle
Observe your child and his friends/classmates in other environments (home, school, play dates, restaurants) to get a comprehensive understanding of his behavior and abilities. Children react and behave differently for many different reasons. Communicate your observations to your therapist so he can accommodate goals for appropriate behavior and learning into target therapy goals. Make sure the therapist is open to hearing about other aspects of the child’s life, not just goals within the setting of therapy. A conscientious therapist will make adjustments to work on goals that will help the child in school and at home.
4. Independence is the goal
An effective therapist moves a child toward independence in an activity or goal. At first there might be a lot of cueing and hand-over-hand work. This should decrease as the child begins to increase in skill level. A good therapist will have the patience to let the child try on his own, rather than always helping just to get results. The goal is to increase the level of expectation until the child has mastered the goal. Staying at one level too long can create a detrimental sense of comfort and a greater resistance to change. A therapist should know when to ease up and when to push. As a child improves and progresses the therapist is adjusting expectations and goals to keep success always at the forefront.
Successful therapy takes a professional, experienced therapist who can keep therapy meaningful, functional and movtivational. By asking the right questions and working as a team, parents and therapists can ensure success.
Vivian Galletly, SLP is the owner of Galletly Speech-Language Services in Marietta. She is a pediatric speech-language pathologist specializing in treatment of autism and Down syndrome. She is also the mother to a 2-year-old girl who has Down syndrome.
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